anonymousstudent

Pay attention as soon as you hit the door. How is the place set up? Where is the nurse's station? Where do they keep supplies? Where do you go to get things for a client such as coffee? Where's the trash? Dirty linens? Don't be writing everything down and miss half of what's going on. It's a lot to take in but it will save you endless trouble later on. When you speak, do so wisely. If you're going to ask a question, make it a good one. Don't ask about something you should already know. (Bring your notes/book incase you need it.) Start off on a good foot with the nurses and patient care staff. They are HELPFUL, especially the latter. Be helpful to them, and you'll get a lot of good experiences. So my basic advice is open your eyes and ears, shut your mouth, and be helpful. Of course you have a lot of other stuff going on, but these things have NEVER failed me.

She can't just not pass you like that. She needs to cough up something better. She needs specific examples of what you are doing wrong or not doing right. Email her and ask her to follow up that comment with some examples and points for improvement.

Well, I guess I didn't have a common experience, but I really struggled with fundamentals and the rest of my stuff has been very easy. Don't let people scare you about med/surge and pharm, etc. You never know how YOU will do in those classes. For me fundamentals was just way too broad. There was no discernible system or pattern to any of it, and it drove me crazy. Now things make a heck of a lot of sense and I did learn what I needed in fundamentals and can do a KA assessment. So, get through it and don't be discouraged. :)

Senioritis starts for me the 3rd week of every.single.term. Good luck, just make yourself do it and get through.

Ugh. You never know when that nausea is going to hit. I find that breathing through my mouth in a new situation is really helpful. At least you know that's probably not the area you should go into!

I LOVED my Mac!!! That thing is still running, all be it very slowly, and it's almost 8 years old. My husband convinced me to get this POS PC I'm now using and I hate it. Get a Mac. You don't have to deal with viruses, the software is easily available so you can be compatible with the rest of the people using PC's, and they last A LOT longer.

I had a clinical instructor tell me that I will never use them when I leave school. Regardless of whether they are done away with or not, nobody's using them. It seems like a ploy to give nurses more professional status or something. Who cares? Everybody knows what nurses do, we don't need a bunch of dxs (that I agree are silly many times) to validate and give legitimacy to what we are doing with our patients.

If priority nursing diagnoses = boring to you, you're going to have a LOOOOONG career. Pick a priority diagnosis and do it well. There are plenty of post-op issues that are far more critical than sexual dysfunction. Of course it's important, but first she needs to get healthy.

Oh yeah, what JBudd said about gathering data from the minute you hit the door is key. A lot of students in my clinicals don't get that and they struggle. Just pay attention. I was working with a student in the nursery a few quarters ago and she took the baby's HR, listened to lungs and bowels. Then she starts documenting and tells me that she needs to go back because she didn't get the quality of his breathing. WHAT? She just spent 5 minutes looking at him breathe. Seriously, pay attention. I know it's easier for some than others, but you can grab a lot of data without even knowing it or trying very hard.

Look, a catheter is a crappy necessity. And yes, it hurts a little. But if you're afraid of hurting somebody, you're going to do a heck of a lot more damage inserting an IV catheter. If you are sensitive about dealing with people's nether regions, that's hard. It will be good though, you will be very aware of your patient's privacy. Of all the things that patients are probably worried about when coming into the hospital, a urinary cath probably ranks pretty low. Keep it in the patient's perspective, not yours.

You will learn each system that way, down to the minutia. You won't really do an assessment like that though. You can be thorough and fast, and get the data you need. Vital signs, including pain! Breath sounds. Heart sounds. Bowels sounds. THEN palpate Pulses. Cap refill (maybe) Edema? Skin - integrity of the IV site, status of incision, etc. Color, temperature, MM's moist or not? Neuro - are they oriented, confused, etc... any numbness? How are they doing with their current situation emotionally? Has family been in? Do they have any concerns? Call light within reach? Bed down? Walker/crutches/whatever close by? Bed rails up? Bed alarm set? Then you add on anything that's pertinent to that specific patient and their care. If they had a head injury or spinal surgery obviously your neuro stuff is going to be more complicated. If they just had a baby you are checking fundus and peri. You need to check drains, tubes, correct IV flow rate, dressings, etc as needed. Just go from top to bottom or whatever makes sense to you. Just find a way to make it make sense and you won't miss anything and you'll be able to go super fast. :)

ITA with her. They are EVERYWHERE though and they are toxic. When I was a manager I would always tell my new hires to find somebody who did thier job well and LIKED it and stick with them until they felt confident.

I would do it as "Risk for Powerlessness." From Carpenito-Moyet: The state in which an individual or group is at risk to perceive a lack of personal control over certain events or situations that affects outlook, goals and lifestlye. Goals: The person will continue to make decisions regarding his/her life, health care and future. Indicators: 1) engage in discussions of options 2) raise questions regarding choices

When you're in a facility it's like walking on egg shells sometimes to get around what you'll see. Pass it up to your CI - that's their job. I saw something once that was flat out ridiculous, major safety issue, and my CI still did nothing about it because the school didn't want to risk the placement over it.

OK. Breathe. When your a student you are not expected to do things perfectly (or shouldn't be). You will make mistakes, that's why you're supervised. You can't base your future performance as a nurse on this one clinical day. Just review what you did wrong, get a plan in place to improve, and talk to your CI and get some additional guidance.